New to this! I need help!

[Baileysmom]

Hello,
Recently my lab Bailey was diagnosed with Cushings (blood work confirmed). The main symptoms I have noticed in him so far are; muscle loss/weakness, increased thirst and increased panting as well as thinning hair on his body.

He will turn 13 in February. He is about 92-94 lbs (a big boy) and has a history with arthritis issues in his hips and knees. I have had him on Adequan injections as well as Tramadol. I also give him Glucosamine, Fish Oil and vitamin supplements to support his liver (since I have him on meds). Recently I started him on Metacam.
I have been freaking out, not knowing what to do for him as I have read that the medication can be worse than the disease. I was hoping for more of a natural remedy, so I started him on Cushex a week ago (haven’t noticed a change either way) and took him for his first treatment for acupuncture this past Wednesday (too soon to know if that has/will help). But I am hoping that the acupuncture can at least help with the arthritis.

Once he was diagnosed, my vet prescribed Vetoryl at 90 mg. I was fearful of starting this because of the side effects, plus the specialist who performed the MRI a couple of weeks ago said that the treatment would cause his arthritis to worsen.
So, on Thursday this past week, I started him on his Vetoryl as prescribed, but continued him on everything else I have been giving him. By Friday, he was noticeably less mobile and by Saturday (yesterday), even worse. He is to the point where he cannot get up by himself and needs support-holding him up and practically carrying him outside to use the restroom (my boyfriend has to help as I cannot lift him by myself). The only think I can gather is that it's the Vertoryl causing this rapid deterioration. I decided to not give him the medication today to see if it would make any difference and increase his mobility. I know the medication is supposed to help with the muscle loss and those symptoms, but what about the arthritis?

So my questions are; What do I do? How quickly does Cushings progress? Does Vetoryl make them worse before they get better?

I don’t want to stop the medication completely and have him get worse with the Cushings stuff, but I don’t want to continue it if that means he will lose all mobility and no longer be able to get around on his own. Does anyone have any advice, suggestions or experience with having the arthritis on top of Cushings??? I want to give him the best quality of life I can for the remainder of the time I have with him. I am very scared and freaked out of doing the wrong thing for him. Help!

Thank You, Julie

[lulusmom]

Hi Julie and welcome to you and Bailey

You have made the right decision to discontinue dosing with Vetoryl. The problem is that the weakness you are describing can also be a sign of low cortisol. Until you figure out whether it's the pain of arthritis that is being unmasked by Vetoryl or the Vetoryl dose is too high, I would not give him anymore. Is Bailey's stool normal, is he still eating and drinking?

If it turns out that Bailey has severe degenerative arthritis that was being masked (self medicated) by high cortisol, I personally would seriously have to reconsider treatment. My own dog, an itty bitty Pom, has serious hip and spine problems and I have already made the decision to not reinstate treatment for her.

Cushing's is a very graded disease and barring complications like diabetes, it takes a very long time to shut down internal organs or completely compromise the immune system, leaving a dog open to massive bacterial infection. Chances are that a newly diagnosed very elderly dog will die of old age or non adrenal illness before cushing's takes their life. It's all about quality of life for our babies and lowering cortisol can compromise the quality of life for some.

Please contact your vet asap and let him/her know what is going on. If Bailey is showing other signs of low cortisol, such as vomiting, diarrhea, no appetite, you need to get him to the vet for testing asap.

We'll be standing by for your update.

Glynda

[Skye]

thinking of you..........wondering how things are going.....sending hugs your way and kisses to snout of your baby. Hope we hear back from you

[Baileysmom]

Thank you for your responses. Yes, Bailey’s stools are normal and he is eating and drinking normally as well. No vomiting or other symptoms like that, just the decrease in mobility and some lethargy. Now, I didn’t give him his Vetoryl today and he was actually trying to get up on his own a little while ago, which is more than he was doing yesterday. Hopefully this continues to improve.

Does anyone have experience with Cushex? Will that lower his Cortisol levels too? Or does it do anything at all? I had heard mostly good things about it, but I am open to feedback. What about acupuncture to help with symptoms and adrenal issues? I know that acupuncture can help with the arthritis pain, but again, I don’t want to be doing anything that will make this worse for him or counteract what I am trying to do for him.

Thanks, Julie

[thewickedpickett]

Hope everything is ok. I'm starting my black lab on vetoryl tomorrow. She has arthritis and previously needed metacam to have decent mobility.

You might also try lazer treatment and water treadmill. Our acupuncturist also uses those as part of her service.

[Baileysmom]

How old is she? How did she do on Metacam? I hear mixed things about this one and am thinking of trying Gabapentin?! Not sure what to do at this point as I am afraid putting mine back on the Vetoryl. He is almost 13 and at this point I would rather him be pain free and mobile than unable to walk. This is so difficult and heart wrenching. Any thoughts?

[Baileysmom]

Thank you. I am willing to try anything at this point.

[molly muffin]

Hello Julie and welcome to the forum. Definitely get the cortisol level checked as it could be that 90mg is too much. With the severe arthritis, sometimes you want to bring the cortisol down, but now down so low that they are completely uncomfortable.
Unfortunately with vetroyl there are at times, several ACTH tests needed to get a handle on what the right dose for any dog is going to be. Plus, like a human, every dog reacts differently to vetroyl. Some need higher doses and some lower according to anything else that might be going on with them and how their bodies react to the drug. While 90mg is the correct dosage recommended, at 1mg per 1 lb. (i believe that is correct) it might not work for Bailey.
please keep us updated as to how things are going. This is a great support forum with most members having gone through some treatment or testing due to cushings diagnosis. Some of our members have been going through this or dealt with it for many years. Some have read every study that has come out regarding cushings testing and dosages. So, you have a lot of information readily available to you.
Also, a quick question, did you have Thyroid and Diabetes ruled out? What were the test numbers? If you could post those it would be very helpful. Did you do an ACTH to diagnose or an LDDS?

Sharlene and Molly Muffin

[Harley PoMMom]

Does anyone have experience with Cushex? Will that lower his Cortisol levels too? Or does it do anything at all? I had heard mostly good things about it, but I am open to feedback.

Thanks, Julie

Hi Julie,

Welcome to you and Bailey. Cushex will be useless in the treatment of Cushing's because it does nothing to lower a dog's elevated cortisol.

Please know we will help in any way we can so do not hesitate to ask any and all questions.

Love and hugs,
Lori

[jmac]

Hi there,
I am with my parents for Christmas, so I only have a minute, and haven't had a chance to read your whole thread, but wanted to let you know weekly acupuncture and laser treatments greatly helped Hannah. With her most recent problem, they followed the acupuncture immediately with laser. Now she gets a laser treatment every 3-4 weeks, and is doing wonderfully, minus some difficulty on icy snow. It definitely sounds like there could be some disc issues. Hannah did not ever turn her feet under and her reflexes were always good. The stumbling only happened when her back was at its worst. I will try to read more tomorrow to catch up. I know you'll get tons of good advice in the meantime. It was about a month of weekly acupuncture before Hannah had optimal improvement.

Take care,

Julie & Hannah

[molly muffin]

In the midst of all of this cushings diagnosing and worry. I want to take the time to wish you are Merry Christmas. Have a safe and wonderful holiday and try to set the worry aside for a bit.

Sharlene and Molly Muffin

[Baileysmom]

I hope everyone had a wonderful Christmas!!

So, Bailey is still having trouble getting up and around on his own. Very weak and wobbly and can’t stand or walk for extended periods of time. He still isn’t back to where he was before I administered the Vertoryl last Thursday (he has been off of it since Sunday). My vet wants me to give him a couple doses of Prednisone to get him over the hump. Then I will start him on the Gabapentin along with the Tramadol and Metacam. I am also going to continue acupuncture and explore laser treatment to address the arthritis and possible spine/nerve issues. I really want to get him back to moving around on his own and feeling better before starting him back on a lower dose of the Vetoryl to address the Cushings. Anyone have any experiences like this or with these particular meds?

It is so difficult and frustrating to watch my baby go through this with minimal improvement and feeling so helpless because I don’t know what to do or what will work or not work for him. I certainly don’t want to make it worse for him. Something has got to give.

[addy]

I know we have many members with experience with those drugs. Hopefully some will stop by. I have been using tramadol for Zoe a few nights a week for her arthritis. I give it to her at bed time as it knocks her out and then next morning she is perkier with walking. I use it 2-3 times a week. I do know a member had good success with underwater treadmill walking for her dogs back leg weakness but I dont know for sure if the pup had nerve damage. All 3 drugs you mention seem to be pretty standard as I see them alot here on the forum.

Sorry you are having a hard time of it right now.

[frijole]

Others may know more than I but I used the tramadol for both my dogs. It can knock a dog out - major drug. My cush dog took it for one night - she walked over to a corner and stared at it and stood there, couldn't stop walking (restless) so I went to bed. Woke up at 2 am to check on her and there was diarrhea all over the living room. Several here had this happen - so when my second dog needed it we went with 1/2 of the recommended dosing and that worked fine.

Re the metacam I never used it because it was not recommended - I thought because she was a cush dog... can't remember and it's early but hopefully someone can give you a better reason later today. :confused::):confused:

Kim

[addy]

I too had to cut the Tramadol dose way down for Zoe. She takes 1/4 of a pill and is 17 pounds. Any more than that and she is "out to lunch";)

[Baileysmom]

Thank you.

[Baileysmom]

Thank you. He seems to tolerate the Tramadol pretty well. I give him about 100 mg twice a day because of his size. They said I can give him up to 150 mg twice a day, but I did notice him sleeping more when I gave him that dose, so I stick with the 100. Hopefully the other stuff will help. Will start him on Prednisolone tonight…

[Baileysmom]

Thank you!

[Baileysmom]

Hello,
So, I am torn as to whether or not to treat my 13 year old lab for Cushing’s (blood work positively diagnosed-Ultrasound showed possible mass on adrenal gland). He was prescribed the Vetoryl and collapsed on me twice with the dosage he was on (90 mg for 94 lb dog), so I stopped immediately and decided to address his mobility issues instead.

After that, I started him on the Metacam, Tramadol and Gabapentin as well as the acupuncture for his arthritis and possible neurological issues (major weakness in hips and back legs, unable to get up off the floor without help, stumbling, back legs crossing over one another, back end shaking when he stands, tail tucked under, back feet/knuckles rolling over when he walked causing him to trip). Since starting him on this regiment, he has been doing much better with getting around and actually getting up off the floor on his own. We also have him walking around as much as possible to exercise.

Now, his symptoms for Cushing’s don’t seem to be as severe as some I’ve read about. He drinks and pants more than usual and his hair is starting to thin out, but that’s about it right now.

What are the pro’s and con’s to treating a 13 year old dog at this point? I don’t want to withhold the treatment for Cushing’s if he needs it (at a much lower dose of course), but I don’t want his mobility to decrease any more or get worse because of the meds either. I just want him to have the best quality of life possible for as long as I am blessed to have him around.

Thanks,
Julie

Moderator's Note: I have moved your update on Bailey into Bailey's original thread. We, normally, like to keep all posts on a pup in a single thread as it makes it easier for other members to refer back to the pup's history, if needed.

[addy]

Hard question to answer. For some reason we see larger dogs needing much smaller doses of Vetoryl, they seem to be more sensitive to it and some just dont tolerate it. Jeanette's Princess, a lab, comes to my mind.

I guess if it were my dog, I would want to know how much of the mobility issues are related to his Cushings and to what degree will lowering his cortisol affect the neurological issues and the arthritis? Will the acupuncture and current drug regime be enough to compensate?

If a dog has severe arthritis and or severe disk problems it would probably be better to leave the cortisol alone.

What does your vet say? Are you seeing a specialist?

[molly muffin]

Well the one thing that leaps out to me is the problems he is having with walking. That could as you have already seen cause problems with that when the cortisol comes down. It's a tough decision because you want to do whatever is best for them. Maybe it would be possible to bring it down with a much lower dose, but I'd make sure that he is doing pretty well and feeling good, after this last bout with the high dose that didn't work for him.

I'm sure others will be along to give their much more experienced thoughts soon.

hugs,
Sharlene and Molly Muffin

[Baileysmom]

Hello Addy,
He has always had some arthritis, but his mobility issues have been getting worse over the past year or so. Again, my vet, along with the vet who does the acupuncture, believe it is neuro due to the movements I listed above. The Vetoryl (lowering his Cortisol) made it all worse.

My vet understands my reasons for not wanting to start him back up on the meds right away, but does recommend that I do so again at some point, maybe starting him at 60 mg. I am just afraid of what it will do to him as the times he collapsed on me; I thought I was losing him. Very scary.

I was just wondering if anyone has ever been in a similar situation struggling to make this call with an older dog. Again, I don't want to not treat the Cushing's but I don't want his mobility to regress again either.


Thanks,
Julie

[Baileysmom]

Thank you Shalene!

[windy]

About Cushex: every time I give 3 drops to my 22 pound cockapoo, he gets much more active and playful. It may not address Cushing's at all for all I know, but clearly it has something in it that energizes. With an old dog, I am not sure if this is good or bad, because I don't want him to tire out from expending false energy that he really doesn't have.

I have the same decision to make about medicating an old dog with presumed Cushing's (strong symptoms, vet says most likely) who also has arthritis. He is also on insulin for diabetes. Both diabetes and Cushing's can cause a lot of peeing inside and thirst. The Cushing's also makes the diabetes a lot harder to handle.

[Baileysmom]

Hello Windy,
I have noticed some changes as far as decrease in panting and less water intake and I am wondering if it is due to the Cushex?! His energy is about the same. He's always been a pretty mellow dog though.

I am sorry you are going through a similar situation. It isn't easy, especially when there are other medical issues involved. I wish you the best in finding a solution that will work best for your dog.

Julie

[Harley PoMMom]

The medications for Cushing's are given to help control the symptoms, unfortunately they are not a cure for this dratted disease.

If Bailey's clinical signs are not bothersome to him or you and the extra cortisol helps with the arthritis pain/mobility, then IMO, I probably wouldn't treat either. It is a tough call to make, just remember nobody knows Bailey as well as YOU do.

Love and hugs,
Lori

[Baileysmom]

Thank you Lori. That makes me feel a little better.
Best,
Julie

[frijole]

Julie, I agree with Lori. I think the cortisol is helping. Sending love, Kim

[Baileysmom]

Thank you Kim. I appreciate the support!

[molly muffin]

You know, it always comes down to one thing. Only you are there with your sweetie and know how things are going, what is bothering Bailey and what isn't. We can tell you options that we've tried and what has worked and what hasn't. Cortisol is a feel better drug and while long term it can contribute to other issues, removing it usually will reveal problems like arthritis and joint issue, that haven't been noticed previously. If you already know this is a very severe issue for Bailey, then you know that removing it will make those issues even more pronounced.
Personally, I probably wouldn't go down that road either. You just have to keep doing what you can to make Bailey as comfortable and mobile as you can. If you ever change your mind and decide you want to try something different, we'll support you on that road too. :) It's sort of what we do around here. lol
So, how is Bailey doing today? :)

hugs,
Sharlene and Molly Muffin

[Baileysmom]

Thank you, Sharlene. I really do appreciate the support of this forum and I have learned so much from everyone on here. I realize that everyone has different situations and circumstances and that different things work for different dogs. I am just trying to figure it all out seeing as I learned about him having Cushing’s later in his life. I don’t want to shorten that life by any means. But again, I just want him comfortable. Maybe I would be more prone to jumping on the medication if he was a little younger and didn’t have the severe issues with his arthritis and mobility.

He has been doing better this past week as opposed to the previous weeks. He has gotten up by himself and has been getting around with less difficulty and with no support from me (which is good!). I am hopeful that something is working here and will continue doing what I’m doing as long as he continues to improve. Then, I will cross the next bridge…

Thank you again for everything Sharlene. I really appreciate you and everyone on here.
Julie